Individual
JANET AGNES BLIVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1119 OWENS ST N, STILLWATER, MN 55082-4316
(651) 275-8364
Mailing address
487 BLUEBIRD DR N, HUDSON, WI 54016-6821
(715) 549-6182
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1654-19
WI
225200000X
Physical Therapy Assistant
Primary
A1200
MN
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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